Abstract

A 22-year-old lady presented to the outpatient department with new onset dyspnoea and effort intolerance. She had a prior history of successful mitral valve repair 5 years previously for symptomatic severe mitral regurgitation, secondary to myxomatous mitral valve prolapse. Clinical examination revealed an undisplaced apex with a parasternal heave (suggestive of right ventricular hypertrophy) and a soft ejection systolic murmur in the pulmonary area.